Microbiota in Pouchitis and De Novo Crohn’s Disease of the Ileal Pouch

Abstract Restorative proctocolectomy with ileal pouch anal anastomosis (IPAA) is the surgical treatment of choice for patients with medically refractory ulcerative colitis or with familial adenomatous polyposis (FAP). Primary idiopathic pouchitis and de novo Crohn’s disease can affect the ileal pouch and cause significant morbidity. Although the cause of both is unknown, abnormalities in the pouch microbiota, coupled with a favorable genetic and immunological context, are thought to play a major pathobiological role in each. The aim of this chapter is to review the literature on the microbiota of the ileal pouch, concentrating on how disturbances of microbiota relate to pouchitis and Crohn’s disease of the pouch.